Coccidioidomycosis Outbreak Among Inmate Wildland Firefighters: California, 2017

Details

• Personal Author:
  Harrison, Robert ; Jain, Seema ; Laws, Rebecca L. ; Leistikow, Bruce ; Materna, Barbara L. ; McNary, Jennifer ; Mohle-Boetani, Janet ; Sondermeyer Cooksey, Gail ; Vugia, Duc C. ; Wilken, Jason ; Windham, Gayle C.
• Description:
  Background: In California, state prison inmates are employed to fight wildfires, which involves performing soil-disrupting work. Wildfires have become more common, including areas where Coccidioides, the soil-dwelling fungus that causes coccidioidomycosis, proliferates. However, work practices that place wildland firefighters at risk for coccidioidomycosis have not been investigated. Methods: On August 17, 2017, the California Department of Public Health was notified of a cluster of coccidioidomycosis cases among Wildfire A inmate wildland firefighters. We collected data through medical record abstraction from suspected case-patients and mailed a survey assessing potential job task risk factors to Wildfire A inmate firefighters. We described respondent characteristics and conducted a retrospective case-control investigation to assess coccidioidomycosis risk factors. Results: Among 198 inmate firefighters who worked on Wildfire A, 112 (57%) completed the survey. Of 10 case-patients (four clinical and six laboratory-confirmed), two were hospitalized. In the case-control analysis of 71 inmate firefighters, frequently cutting fire lines with a McLeod tool (odds ratio [OR]: 5.5; 95% confidence interval [CI]: 1.1-37.2) and being in a dust cloud or storm (OR: 4.3; 95% CI: 1.1-17.4) were associated with illness. Two of 112 inmate firefighters reported receiving coccidioidomycosis training; none reported wearing respiratory protection on this wildfire. Conclusions: Wildland firefighters who use hand tools and work in dusty conditions where Coccidioides proliferates are at risk for coccidioidomycosis. Agencies that employ them should provide training about coccidioidomycosis and risk reduction, limit dust exposure, and implement respiratory protection programs that specify where respirator use is feasible and appropriate. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Dust Firefighters Fires Occupational Health Respiratory Protective Devices Safety Wildfires
• Keywords:
  Author Keywords: California Case Control Studies Coccidioides Coccidioidomycosis Dust Exposure Fire Fighters Fungal Infections Infectious Diseases Inmates Respiratory Protective Equipment Valley Fever Wildland Firefighters

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  8 pdf pages
• Volume:
  64
• NIOSHTIC Number:
  nn:20066538
• Citation:
  Am J Ind Med 2021 Apr; 64(4):266-273
• Contact Point Address:
  Rebecca L. Laws, Epidemic Intelligence Service, Division of Scientific Education and Professional Development, US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS US1-2, Atlanta, GA 30333, USA
• Email:
  lxq2@cdc.gov
• Federal Fiscal Year:
  2021
• Performing Organization:
  Public Health Institute
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9b69a3f407a40753759aaaa5a69b0ec27016e37cd1549adccd00ed965edaeb18a1c8e97250201a9ef72f44787db4c8e07d28a52cb2ab77ca837d19b6dc73efc9
• Download URL:
  https://stacks.cdc.gov/view/cdc/230767/cdc_230767_DS1.pdf
• File Type:
  [PDF - 605.27 KB ]